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Lean six sigma

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https://www.readbyqxmd.com/read/28723845/lean-six-sigma-techniques-to-improve-ophthalmology-clinic-efficiency
#1
Thomas A Ciulla, Mohan V Tatikonda, Yehya A ElMaraghi, Rehan M Hussain, Amanda L Hill, Julie M Clary, Eyas Hattab
PURPOSE: Ophthalmologists serve an increasing volume of a growing elderly population undergoing increasingly complex outpatient medical care, including extensive diagnostic testing and treatment. The resulting prolonged patient visit times ("patient flow times") limit quality, patient and employee satisfaction, and represent waste. Lean Six Sigma process improvement was used in a vitreoretinal practice to decrease patient flow time, demonstrating that this approach can yield significant improvement in health care...
July 18, 2017: Retina
https://www.readbyqxmd.com/read/28679887/telehealth-and-the-re-design-of-emergency-medical-services
#2
Richard W Jones, George Despotou, Theodoros N Arvanitis
As patient numbers continue to rise Emergency Department's (ED's) are struggling to not only control patient wait times but also to maintain the quality of patient care. Improving patient flow through the ED has been a priority for many years with techniques such as Lean Six-Sigma being implemented specifically to help alleviate the problem. The Institute for Healthcare Improvement recently stated that the best opportunities to improving patient flow relate to the front-end of the ED, namely triage. This contribution examines the use of Telehealth initiatives at the front-end of the ED, specifically tele-consultation, to reduce patient loading, provide timelier healthcare (with improved patient outcomes) and reduce costs...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28674608/experiences-with-lean-six-sigma-as-improvement-strategy-to-reduce-parenteral-medication-administration-errors-and-associated-potential-risk-of-harm
#3
Afke van de Plas, Mariëlle Slikkerveer, Saskia Hoen, Rick Schrijnemakers, Johanna Driessen, Frank de Vries, Patricia van den Bemt
In this controlled before-after study the effect of improvements, derived from Lean Six Sigma strategy, on parenteral medication administration errors and the potential risk of harm was determined. During baseline measurement, on control versus intervention ward, at least one administration error occurred in 14 (74%) and 6 (46%) administrations with potential risk of harm in 6 (32%) and 1 (8%) administrations. Most administration errors with high potential risk of harm occurred in bolus injections: 8 (57%) versus 2 (67%) bolus injections were injected too fast with a potential risk of harm in 6 (43%) and 1 (33%) bolus injections on control and intervention ward...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28649480/the-role-of-organizational-culture-in-operating-room-turnaround-time
#4
David Ninan, Janet Zhu, Amanda Kore, Elizabeth Wasson, Tricia Fullerton, Barbara Ninan
This analysis looks at the application of a robust process improvement methodology to achieve a sustained organizational change. The implementation took place in a safety net hospital's operating suites that had a problem with relatively long, nonproductive turnover times between surgical procedures. Organizational leadership empowered stakeholders to use Lean and Six-Sigma tools to develop more efficient organizational processes. These processes were then implemented in a phased approach with careful attention to the organization's culture...
May 17, 2017: Curēus
https://www.readbyqxmd.com/read/28635297/medical-students-leading-quality-improvement-a-lean-six-sigma-approach-to-pain-management
#5
David Droullard, Samuel Porter, Anna Zuckerman, Daphne Monie, Judi Brendle, Henry Weil
No abstract text is available yet for this article.
June 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28614432/characteristics-of-nursing-professionals-and-the-practice-of-ecologically-sustainable-actions-in-the-medication-processes
#6
Patricia de Oliveira Furukawa, Isabel Cristina Kowal Olm Cunha, Mavilde da Luz Gonçalves Pedreira, Patricia Beryl Marck
Objectives: to verify the correlation between the characteristics of professionals and the practice of sustainable actions in the medication processes in an ICU, and to determine if interventions such as training and awareness can promote sustainable practices performed by nursing staff in the hospital. Methods: before-and-after design study using Lean Six Sigma methodology, applied in an intensive care unit. Nursing staff were observed regarding the practice of ecologically sustainable actions during medication processes (n = 324 cases for each group (pre and post-intervention)) through a data collection instrument...
June 8, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28614127/a-hospital-is-not-just-a-factory-but-a-complex-adaptive-system-implications-for-perioperative-care
#7
Aman Mahajan, Salim D Islam, Michael J Schwartz, Maxime Cannesson
Many methods used to improve hospital and perioperative services productivity and quality of care have assumed that the hospital is essentially a factory, and therefore, that industrial engineering and manufacturing-derived redesign approaches such as Six Sigma and Lean can be applied to hospitals and perioperative services just as they have been applied in factories. However, a hospital is not merely a factory but also a complex adaptive system (CAS). The hospital CAS has many subsystems, with perioperative care being an important one for which concepts of factory redesign are frequently advocated...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28552386/tools-and-methods-for-quality-improvement-and-patient-safety-in-perinatal-care
#8
Amy T Nathan, Heather C Kaplan
The quality of health care is now recognized to vary widely in all medical specialties, including perinatal medicine. A national focus on quality improvement (QI) and patient safety is prompting providers to change and improve the care given to patients. All QI and safety efforts require the use of an improvement model to manage the complex process of improving care. This article reviews the most common frameworks in use today, including the Model for Improvement, Six Sigma, and Lean. Specific tools such as affinity, key driver and fishbone diagrams, process maps and statistical process control, as well as checklists are reviewed, with examples from the perinatal literature to illustrate their use in perinatal QI efforts...
April 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28538055/high-reliability-principles-must-be-tied-to-value-based-outcomes
#9
Mitchell L Wasden
WellStar Health System and the Medical University of South Carolina (MUSC), highlighted in this issue's feature articles, are two organizations seeking to drive high reliability by educating leaders and incorporating high-reliability principles into their quality improvement (QI) efforts. The organizations have taken slightly different approaches to executing on high reliability, yet both are encouraged by the apparent success of high-reliability principles in other industries.The high-reliability framework is often applied to healthcare despite the limitations of comparing healthcare organizations to nuclear reactors, commercial airlines, and aircraft carriers...
July 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28494624/an-overview-of-the-performance-improvement-initiatives-by-the-ministry-of-health-in-the-kingdom-of-saudi-arabia
#10
Mazen Hassanain
Saudi Arabia's Ministry of Health (MOH) use corporate performance improvement methodologies to develop and implement performance improvement initiatives designed to continue building on the Ministry's vision of transforming hospital operations and instituting a culture of quality and performance focused on the "patient first" principle. We evaluated the feasibility of setting up a performance improvement unit (PIU) within the MOH to apply the principles of Lean Six Sigma and to change management methodologies...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28461170/lean-six-sigma-approach-to-improving-interventional-radiology-scheduling
#11
Joshua D Dowell, Mina S Makary, Mathew Brocone, James G Sarbinoff, Ivan G Vargas, Mrinalini Gadkari
No abstract text is available yet for this article.
April 28, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28421225/using-telephony-data-to-facilitate-discovery-of-clinical-workflows
#12
Donald W Rucker
BACKGROUND:  Discovery of clinical workflows to target for redesign using methods such as Lean and Six Sigma is difficult. VoIP telephone call pattern analysis may complement direct observation and EMR-based tools in understanding clinical workflows at the enterprise level by allowing visualization of institutional telecommunications activity. OBJECTIVE:  To build an analytic framework mapping repetitive and high-volume telephone call patterns in a large medical center to their associated clinical units using an enterprise unified communications server log file and to support visualization of specific call patterns using graphical networks...
April 19, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28410337/adaptation-of-lean-six-sigma-methodologies-for-the-evaluation-of-veterans-choice-program-at-3-urban-veterans-affairs-medical-centers
#13
Sherry L Ball, Lauren D Stevenson, Amy C Ladebue, Marina S McCreight, Emily C Lawrence, Taryn Oestreich, Anne C Lambert-Kerzner
OBJECTIVE: The Veterans Health Administration (VHA) is adapting to meet the changing needs of our Veterans. VHA leaders are promoting quality improvement strategies including Lean Six Sigma (LSS). This study used LSS tools to evaluate the Veterans Choice Program (VCP), a program that aims to improve access to health care services for eligible Veterans by expanding health care options to non-VHA providers. RESEARCH DESIGN: LSS was utilized to assess the current process and efficiency patterns of the VCP at 3 VHA Medical Centers...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28389078/improving-operating-room-efficiency-in-academic-children-s-hospital-using-lean-six-sigma-methodology
#14
Edward P Tagge, Arul S Thirumoorthi, John Lenart, Carlos Garberoglio, Kenneth W Mitchell
BACKGROUND/PURPOSE: Lean Six Sigma (LSS) is a process improvement methodology that utilizes a collaborative team effort to improve performance by systematically identifying root causes of problems. Our objective was to determine whether application of LSS could improve efficiency when applied simultaneously to all services of an academic children's hospital. METHODS: In our tertiary academic medical center, a multidisciplinary committee was formed, and the entire perioperative process was mapped, using fishbone diagrams, Pareto analysis, and other process improvement tools...
June 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28358788/an-application-of-business-process-management-to-health-care-facilities
#15
Mohsen M D Hassan
The purpose of this article is to help health care facility managers and personnel identify significant elements of their facilities to address, and steps and actions to follow, when applying business process management to them. The ABPMP (Association of Business Process Management Professionals) life-cycle model of business process management is adopted, and steps from Lean, business process reengineering, and Six Sigma, and actions from operations management are presented to implement it. Managers of health care facilities can find in business process management a more comprehensive approach to improving their facilities than Lean, Six Sigma, business process reengineering, and ad hoc approaches that does not conflict with them because many of their elements can be included under its umbrella...
April 2017: Health Care Manager
https://www.readbyqxmd.com/read/28277381/working-toward-quality-in-obstetric-anesthesia-a-business-approach
#16
Grant C Lynde
PURPOSE OF REVIEW: Physicians are increasingly required to demonstrate that they provide quality care. How does one define quality? A significant body of literature in industries outside of health care provides guidance on how to define appropriate metrics, create teams to troubleshoot problem areas, and sustain those improvements. RECENT FINDINGS: The modern quality movement in the United States began in response to revolutionary gains in both quality and productivity in Japanese manufacturing in the 1980's...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28212907/improving-preoperative-throughput
#17
Jennifer Franklin, Tony Franklin
Preoperative throughput is an important piece in achieving the perioperative goal for first case on time starts. An inefficient preoperative (preop) department can delay surgery starts and impact the patient flow throughout the day. Research is abundant in applying lean six sigma principles in the operating room, however there are minimal studies that specifically apply these tools in the preop. The perioperative process includes the preop, operating room, and the postoperative departments. All areas have to run like a well-oiled machine to improve performance and achieve positive outcomes...
February 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28205271/lean-six-sigma-methodologies-improve-clinical-laboratory-efficiency-and-reduce-turnaround-times
#18
Tamer C Inal, Ozlem Goruroglu Ozturk, Filiz Kibar, Salih Cetiner, Selcuk Matyar, Gulcin Daglioglu, Akgun Yaman
BACKGROUND: Organizing work flow is a major task of laboratory management. Recently, clinical laboratories have started to adopt methodologies such as Lean Six Sigma and some successful implementations have been reported. This study used Lean Six Sigma to simplify the laboratory work process and decrease the turnaround time by eliminating non-value-adding steps. METHODS: The five-stage Six Sigma system known as define, measure, analyze, improve, and control (DMAIC) is used to identify and solve problems...
February 15, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28183346/study-protocol-improving-the-transition-of-care-from-a-non-network-hospital-back-to-the-patient-s-medical-home
#19
Roman A Ayele, Emily Lawrence, Marina McCreight, Kelty Fehling, Jamie Peterson, Russell E Glasgow, Borsika A Rabin, Robert Burke, Catherine Battaglia
BACKGROUND: The process of transitioning Veterans to primary care following a non-Veterans Affairs (VA) hospitalization can be challenging. Poor transitions result in medical complications and increased hospital readmissions. The goal of this transition of care quality improvement (QI) project is to identify gaps in the current transition process and implement an intervention that bridges the gap and improves the current transition of care process within the Eastern Colorado Health Care System (ECHCS)...
February 10, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28152722/integrating-lean-six-sigma-in-the-daily-operations-of-an-icu-to-achieve-safe-quality-patient-care
#20
Jacqueline Magurn, Joanne McGovern, Michelle Jetter, Sarah Beadling, Dorothy Gregoire
230 Background: Developing and maintaining a culture of safety and quality in delivering patient care is critical in the intensive care unit (ICU) especially an oncology ICU. Incorporating the Lean Six Sigma program into daily operations of the ICU achieves, simplifies, and sustains continuous improvement in the delivery of safe quality patient care. This program engages the ICU team through visual management of quality, safety, and budget indicators including medication scanning, falls, sharps exposure, infection prevention including blood stream, catheter, hospital and ventilator acquired pneumonias, venous embolism prevention, and staffing compliance...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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